Document Detail


Glucagon-like peptide-1 (GLP-1) attenuates post-resuscitation myocardial microcirculatory dysfunction.
MedLine Citation:
PMID:  20347207     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM OF THE STUDY: Post-resuscitation syndrome leads to death in approximately 2 out of every 3 successfully resuscitated victims, and myocardial microcirculatory dysfunction is a major component of this syndrome. The aim of this study was to determine if glucagon-like peptide-1 (GLP-1) improves post-resuscitation myocardial microcirculatory function. METHODS: Ventricular fibrillation (VF) was induced electrically in 20 anesthetized domestic swine (30-35 kg). Following 8 min of untreated VF, animals were resuscitated with aggressive advanced cardiac life support (ACLS). Animals were blindly randomized to receive a continuous infusion of either GLP-1 (10 pM/kg/min) or equal volume saline as placebo (PBO) for 4h, beginning 1 min after return of spontaneous circulation (ROSC). Left ventricular (LV) haemodynamics, LV ejection fraction, cardiac output, and coronary flow reserve (CFR) [using a standard technique of intracoronary Doppler flow measurements before and after intracoronary administration of 60 microg adenosine] were performed pre-arrest and at 1 and 4h post-resuscitation. In the present study, CFR is a measure of myocardial microcirculatory function since these swine had no obstructive coronary artery disease. Twenty-four hour post-resuscitation survival and neurological functional scores were also determined. RESULTS: CFR was significantly increased in GLP-1-treated animals, 1h (1.79+/-0.13 in control animals vs. 2.05+/-0.12 in GLP-1-treated animals, P = <0.05) and 4h (1.82+/-0.16 in control animals vs. 2.31+/-0.13 in GLP-1-treated animals, P = <0.05) after ROSC. In addition, compared to PBO-treated animals, GLP-1 increased cardiac output 1h after ROSC (2.1+/-0.1 in control animals vs. 2.7+/-0.2 in GLP-1-treated animals, P = <0.05). There was no statistically significant difference in survival between GLP-1-treated (100%) and PBO-treated animals (78%). CONCLUSIONS: In this swine model of prolonged VF followed by successful resuscitation, myocardial microcirculatory function was enhanced with administration of GLP-1. However, GLP-1 treatment was not associated with a clinically significant improvement in post-resuscitation myocardial function.
Authors:
Betsy B Dokken; W Ronald Hilwig; Mary K Teachey; R Ashish Panchal; Karl Hubner; Daniel Allen; David C Rogers; Karl B Kern
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-26
Journal Detail:
Title:  Resuscitation     Volume:  81     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-17     Completed Date:  2010-09-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  755-60     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Medicine, University of Arizona, Tucson, AZ, USA. bdokken@deptofmed.arizona.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Glucose / analysis
Cardiac Output / drug effects
Cardiopulmonary Resuscitation / adverse effects*
Coronary Circulation / drug effects
Coronary Disease / drug therapy*,  etiology*,  physiopathology
Glucagon-Like Peptide 1 / administration & dosage*
Heart / physiopathology
Hemodynamics
Humans
Infusion Pumps
Insulin / blood
Lactic Acid / blood
Microcirculation / drug effects*
Nervous System / physiopathology
Osmolar Concentration
Survival Rate
Swine
Time Factors
Ventricular Fibrillation / therapy*
Chemical
Reg. No./Substance:
0/Blood Glucose; 11061-68-0/Insulin; 50-21-5/Lactic Acid; 89750-14-1/Glucagon-Like Peptide 1

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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